Provider Demographics
NPI:1790876993
Name:SKEFICH, SYLVIA MARIE (DC)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:MARIE
Last Name:SKEFICH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 41ST AVE
Mailing Address - Street 2:STE G
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062
Mailing Address - Country:US
Mailing Address - Phone:831-475-1995
Mailing Address - Fax:831-475-2105
Practice Address - Street 1:920 41ST AVE
Practice Address - Street 2:STE G
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062
Practice Address - Country:US
Practice Address - Phone:831-475-1995
Practice Address - Fax:831-475-2105
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25805111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0258050Medicare ID - Type Unspecified
CA6DD63Medicare PIN